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Pain Management Following Thoracic Surgery

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Postoperative Care in Thoracic Surgery

Abstract

Pain after thoracotomy is intense, and uncontrolled pain can have negative consequences such as impaired respiratory function, delayed recovery, and transition to chronic pain. The aim is to achieve efficient analgesia without further compromising respiratory system or increasing unwanted complication risks with a multimodal regimen. For this reason, thoracic epidural analgesia and recently paravertebral blocks have gained popularity. Proper preparation followed by comprehensive teamwork and meticulous follow-up can ensure patient comfort and safety.

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References

  1. Belda J, Cavalcanti M, Ferrer M, Serra M, Puig de la Bellacasa J, Canalis E, Torres A (2005) Bronchial colonization and postoperative respiratory infections in patients undergoing lung cancer surgery. Chest 128:1571–1579

    Article  PubMed  Google Scholar 

  2. Harris DJ, Hilliard PE, Jewell ES, Brummett CM (2015) The association between incentive spirometry performance and pain in postoperative thoracic epidural analgesia. Reg Anesth Pain Med 40:232–238

    Article  CAS  PubMed  Google Scholar 

  3. Sentürk M, Ozcan PE, Talu GK, Kiyan E, Camci E, Ozyalçin S, Dilege S, Pembeci K (2002) The effects of three different analgesia techniques on long-term postthoracotomy pain. Anesth Analg 94:11–15

    Article  PubMed  Google Scholar 

  4. Classification of chronic pain. Descriptions of chronic pain syndromes and definitions of pain terms. Prepared by the International Association for the Study of Pain, Subcommittee on Taxonomy (1986) Pain Suppl 3:S1–226

    Google Scholar 

  5. Maxwell C, Nicoara A (2014) New developments in the treatment of acute pain after thoracic surgery. Curr Opin Anaesthesiol 27:6–11

    Article  PubMed  Google Scholar 

  6. De Cosmo G, Aceto P, Gualtieri E, Congedo E (2009) Analgesia in thoracic surgery: review. Minerva Anestesiol 75:393–400

    PubMed  Google Scholar 

  7. Kolettas A, Lazaridis G, Baka S, Mpoukovinas I, Karavasilis V, Pitsiou G, Papaiwannou A, Lampaki S, Karavergou A, Machairiotis N, Katsikogiannis N, Mpakas A, Tsakiridis K, Fassiadis N, Zarogoulidis K, Zarogoulidis P (2015) Postoperative pain management. J Thorac Dis 7:62–72

    Google Scholar 

  8. Koehler RP, Keenan RJ (2006) Management of postthoracotomy pain: acute and chronic. Thorac Surg Clin 16:287–297

    Article  PubMed  Google Scholar 

  9. Bottiger BA, Esper SA, Stafford-Smith M (2014) Pain management strategies for thoracotomy and thoracic pain syndromes. Semin Cardiothorac Vasc Anesth 18:45–56

    Article  PubMed  Google Scholar 

  10. Doan LV, Augustus J, Androphy R, Schechter D, Gharibo C (2014) Mitigating the impact of acute and chronic post-thoracotomy pain. J Cardiothorac Vasc Anesth 28:1048–1056

    Article  PubMed  Google Scholar 

  11. Rodriguez-Aldrete D, Candiotti KA, Janakiraman R, Rodriguez-Blanco YF (2016) Trends and new evidence in the management of acute and chronic post-thoracotomy pain – an overview of the literature from 2005 to 2015. J Cardiothorac Vasc Anesth 30:762–772

    Article  PubMed  Google Scholar 

  12. Katz J, Jackson M, Kavanagh BP, Sandler AN (1996) Acute pain after thoracic surgery predicts long-term post-thoracotomy pain. Clin J Pain 12:50–55

    Article  CAS  PubMed  Google Scholar 

  13. Dürrleman N, Massard G (2006) Posterolateral thoracotomy. Multimed Man Cardiothorac Surg MMCTS/Eur Assoc Cardio-Thoracic Surg 2006:mmcts.2005.001453

    Google Scholar 

  14. Hazelrigg SR, Cetindag IB, Fullerton J (2002) Acute and chronic pain syndromes after thoracic surgery. Surg Clin North Am 82:849–865

    Article  PubMed  Google Scholar 

  15. Li S (2014) Analysis of 11 trials comparing muscle-sparing with posterolateral thoracotomy. Thorac Cardiovasc Surg 62:344–354

    Article  PubMed  Google Scholar 

  16. Elshiekh MAF, Lo TTH, Shipolini AR, Mccormack DJ (2013) Does muscle-sparing thoracotomy as opposed to posterolateral thoracotomy result in better recovery ? Interact Cardiovasc Thorac Surg 16:60–67

    Article  PubMed  Google Scholar 

  17. Hazelrigg SR, Landreneau RJ, Boley TM, Priesmeyer M, Schmaltz RA, Nawarawong W, Johnson JA, Walls JT, Curtis JJ (1991) The effect of muscle-sparing versus standard posterolateral thoracotomy on pulmonary function, muscle strength, and postoperative pain. J Thorac Cardiovasc Surg 101:394–400; discussion 400–1

    CAS  PubMed  Google Scholar 

  18. Landreneau RJ, Mack MJ, Hazelrigg SR, Naunheim K, Dowling RD, Ritter P, Magee MJ, Nunchuck S, Keenan RJ, Ferson PF (1994) Prevalence of chronic pain after pulmonary resection by thoracotomy or video-assisted thoracic surgery. J Thorac Cardiovasc Surg 107:1079–1085; discussion 1085–6

    CAS  PubMed  Google Scholar 

  19. Bertrand PC, Regnard JF, Spaggiari L, Levi JF, Magdeleinat P, Guibert L, Levasseur P (1996) Immediate and long-term results after surgical treatment of primary spontaneous pneumothorax by VATS. Ann Thorac Surg 61:1641–1645

    Article  CAS  PubMed  Google Scholar 

  20. Gottschalk A, Cohen SP, Yang S, Ochroch EA (2006) Preventing and treating pain after thoracic surgery. Anesthesiology 104:594–600

    Article  PubMed  Google Scholar 

  21. Sabanathan S, Eng J, Mearns AJ (1990) Alterations in respiratory mechanics following thoracotomy. J R Coll Surg Edinb 35:144–150

    CAS  PubMed  Google Scholar 

  22. Van Mieghem W, Demedts M (1989) Cardiopulmonary function after lobectomy or pneumonectomy for pulmonary neoplasm. Respir Med 83:199–206

    Article  PubMed  Google Scholar 

  23. Hedenstierna G, Strandberg A, Brismar B, Lundquist H, Svensson L, Tokics L (1985) Functional residual capacity, thoracoabdominal dimensions, and central blood volume during general anesthesia with muscle paralysis and mechanical ventilation. Anesthesiology 62:247–254

    Article  CAS  PubMed  Google Scholar 

  24. Hatch D (1966) Ventilation and arterial oxygenation during thoracic surgery. Thorax 21:310–314

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Richardson J, Sabanathan S, Shah R (1999) Post-thoracotomy spirometric lung function: the effect of analgesia. A review. J Cardiovasc Surg (Torino) 40:445–456

    CAS  Google Scholar 

  26. Scawn ND, Pennefather SH, Soorae A, Wang JY, Russell GN (2001) Ipsilateral shoulder pain after thoracotomy with epidural analgesia: the influence of phrenic nerve infiltration with lidocaine. Anesth Analg 93:260–264

    CAS  PubMed  Google Scholar 

  27. Møiniche S, Kehlet H, Dahl JB (2002) A qualitative and quantitative systematic review of preemptive analgesia for postoperative pain relief. Anesthesiology 96:725–741

    Article  PubMed  Google Scholar 

  28. Cerfolio RJ, Bryant AS, Bass CS, Bartolucci AA (2003) A prospective, double-blinded, randomized trial evaluating the use of preemptive analgesia of the skin before thoracotomy. Ann Thorac Surg 76:1055–1058

    Article  PubMed  Google Scholar 

  29. Katz J, Clarke H, Seltzer Z (2011) Preventive analgesia: quo vadimus? Anesth Analg 113:1242–1253

    Article  PubMed  Google Scholar 

  30. Bong CL, Samuel M, Ng JM, Ip-Yam C (2005) Effects of preemptive epidural analgesia on post-thoracotomy pain. J Cardiothorac Vasc Anesth 19:786–793

    Article  PubMed  Google Scholar 

  31. Joshi GP, Bonnet F, Shah R, Wilkinson RC, Camu F, Fischer B, Neugebauer EAM, Rawal N, Schug SA, Simanski C, Kehlet H (2008) A systematic review of randomized trials evaluating regional techniques for postthoracotomy analgesia. Anesth Analg 107:1026–1040

    Article  CAS  PubMed  Google Scholar 

  32. Procedure specific postoperative pain management. http://www.postoppain.org

  33. Ali M, Winter DC, Hanly AM, O’Hagan C, Keaveny J, Broe P (2010) Prospective, randomized, controlled trial of thoracic epidural or patient-controlled opiate analgesia on perioperative quality of life. Br J Anaesth 104:292–297

    Article  CAS  PubMed  Google Scholar 

  34. Bauer C, Hentz J-G, Ducrocq X, Meyer N, Nicolas M, Oswald-Mammosser M, Steib A, Dupeyron J-P (2007) Lung function after lobectomy: a randomized, double-blinded trial comparing thoracic epidural ropivacaine/sufentanil and intravenous morphine for patient-controlled analgesia. Anesth Analg 105:238–244

    Article  CAS  PubMed  Google Scholar 

  35. Ballantyne JC, Carr DB, DeFerranti S, Suarez T, Lau J, Chalmers TC, Angelillo IF, Mosteller F (1998) The comparative effects of postoperative analgesic therapies on pulmonary outcome: cumulative meta-analyses of randomized, controlled trials. Anesth Analg 86:598–612

    Article  CAS  PubMed  Google Scholar 

  36. Pöpping DM, Elia N, Marret E, Remy C, Tramèr MR (2008) Protective effects of epidural analgesia on pulmonary complications after abdominal and thoracic surgery: a meta-analysis. Arch Surg 143:990–999; discussion 1000

    Article  PubMed  Google Scholar 

  37. Freise H, Van Aken HK (2011) Risks and benefits of thoracic epidural anaesthesia. Br J Anaesth 107:859–868

    Article  CAS  PubMed  Google Scholar 

  38. Oka T, Ozawa Y, Ohkubo Y (2001) Thoracic epidural bupivacaine attenuates supraventricular tachyarrhythmias after pulmonary resection. Anesth Analg 93:253–259, 1st contents page

    CAS  PubMed  Google Scholar 

  39. Ng A, Swanevelder J (2007) Pain relief after thoracotomy: is epidural analgesia the optimal technique? Br J Anaesth 98:159–162

    Article  CAS  PubMed  Google Scholar 

  40. Drasner K (2004) Thoracic epidural anesthesia: asleep at the wheal? Anesth Analg 99:578–579

    Article  PubMed  Google Scholar 

  41. Manion SC, Brennan TJ (2011) Thoracic epidural analgesia and acute pain management. Anesthesiology 115:181–188

    Article  PubMed  Google Scholar 

  42. Visser WA, Lee RA, Gielen MJM (2008) Factors affecting the distribution of neural blockade by local anesthetics in epidural anesthesia and a comparison of lumbar versus thoracic epidural anesthesia. Anesth Analg 107:708–721

    Article  CAS  PubMed  Google Scholar 

  43. Sagiroglu G, Meydan B, Copuroglu E, Baysal A, Yoruk Y, Altemur Karamustafaoglu Y, Huseyin S (2014) A comparison of thoracic or lumbar patient-controlled epidural analgesia methods after thoracic surgery. World J Surg Oncol 12:96

    Article  PubMed  PubMed Central  Google Scholar 

  44. Engquist A, Brandt MR, Fernandes A, Kehlet H (1977) The blocking effect of epidural analgesia on the adrenocortical and hyperglycemic responses to surgery. Acta Anaesthesiol Scand 21:330–335

    Article  CAS  PubMed  Google Scholar 

  45. Bouchard F, Drolet P (1995) Thoracic versus lumbar administration of fentanyl using patient-controlled epidural after thoracotomy. Reg Anesth 20:385–388

    CAS  PubMed  Google Scholar 

  46. Grant GJ, Zakowski M, Ramanathan S, Boyd A, Turndorf H (1993) Thoracic versus lumbar administration of epidural morphine for postoperative analgesia after thoracotomy. Reg Anesth 18:351–355

    CAS  PubMed  Google Scholar 

  47. Liu N, Kuhlman G, Dalibon N, Moutafis M, Levron JC, Fischler M (2001) A randomized, double-blinded comparison of intrathecal morphine, sufentanil and their combination versus IV morphine patient-controlled analgesia for postthoracotomy pain. Anesth Analg 92:31–36

    Article  CAS  PubMed  Google Scholar 

  48. Senturk M (2005) Acute and chronic pain after thoracotomies. Curr Opin Anaesthesiol 18:1–4

    Article  PubMed  Google Scholar 

  49. Hansdottir V, Woestenborghs R, Nordberg G (1995) The cerebrospinal fluid and plasma pharmacokinetics of sufentanil after thoracic or lumbar epidural administration. Anesth Analg 80:724–729

    CAS  PubMed  Google Scholar 

  50. Dernedde M, Stadler M, Bardiau F, Seidel L, Boogaerts JG (2006) Low vs. high concentration of levobupivacaine for post-operative epidural analgesia: Influence of mode of delivery. Acta Anaesthesiol Scand 50:613–621

    Article  CAS  PubMed  Google Scholar 

  51. Tan CNH, Guha A, Scawn NDA, Pennefather SH, Russell GN (2004) Optimal concentration of epidural fentanyl in bupivacaine 0.1% after thoracotomy. Br J Anaesth 92:670–674

    Article  CAS  PubMed  Google Scholar 

  52. Ozcan PE, Sentürk M, Sungur Ulke Z, Toker A, Dilege S, Ozden E, Camci E (2007) Effects of thoracic epidural anaesthesia on pulmonary venous admixture and oxygenation during one-lung ventilation. Acta Anaesthesiol Scand 51:1117–1122

    Article  CAS  PubMed  Google Scholar 

  53. Bilir A, Gulec S, Erkan A, Ozcelik A (2007) Epidural magnesium reduces postoperative analgesic requirement. Br J Anaesth 98:519–523

    Article  CAS  PubMed  Google Scholar 

  54. Ozyalcin NS, Yucel A, Camlica H, Dereli N, Andersen OK, Arendt-Nielsen L (2004) Effect of pre-emptive ketamine on sensory changes and postoperative pain after thoracotomy: comparison of epidural and intramuscular routes. Br J Anaesth 93:356–361

    Article  CAS  PubMed  Google Scholar 

  55. Matot I, Drenger B, Weissman C, Shauli A, Gozal Y (2004) Epidural clonidine, bupivacaine and methadone as the sole analgesic agent after thoracotomy for lung resection. Anaesthesia 59:861–866

    Article  CAS  PubMed  Google Scholar 

  56. Zeng XZ, Xu YM, Cui XG, Guo YP, Li WZ (2014) Low-dose epidural dexmedetomidine improves thoracic epidural anaesthesia for nephrectomy. Anaesth Intensive Care 42:185–190

    CAS  PubMed  Google Scholar 

  57. Chia Y-Y, Chang T-H, Liu K, Chang H-C, Ko N-H, Wang Y-M (2006) The efficacy of thoracic epidural neostigmine infusion after thoracotomy. Anesth Analg 102:201–208

    Article  PubMed  Google Scholar 

  58. Rawal N (2015) Current issues in postoperative pain management. Eur J Anaesthesiol 33:160–171

    Article  Google Scholar 

  59. Romero A, Garcia JEL, Joshi GP (2013) The state of the art in preventing postthoracotomy pain. Semin Thorac Cardiovasc Surg 25:116–124

    Article  PubMed  Google Scholar 

  60. Yeung JHY, Gates S, Naidu B V, Wilson MJA, Gao Smith F (2016) Paravertebral block versus thoracic epidural for patients undergoing thoracotomy. Cochrane Database Syst Rev (2):CD009121

    Google Scholar 

  61. Kotzé A, Scally A, Howell S (2009) Efficacy and safety of different techniques of paravertebral block for analgesia after thoracotomy: a systematic review and metaregression. Br J Anaesth 103:626–636

    Article  PubMed  Google Scholar 

  62. Fagenholz PJ, Bowler GMR, Carnochan FM, Walker WS (2012) Systemic local anaesthetic toxicity from continuous thoracic paravertebral block. Br J Anaesth 109:260–262

    Article  CAS  PubMed  Google Scholar 

  63. Tighe S (2013) The safety of paravertebral nerve block. Anaesthesia 68:783

    Article  CAS  PubMed  Google Scholar 

  64. Luyet C, Siegenthaler A, Szucs-Farkas Z, Hummel G, Eichenberger U, Vogt A (2012) The location of paravertebral catheters placed using the landmark technique. Anaesthesia 67:1321–1326

    Article  CAS  PubMed  Google Scholar 

  65. Krediet AC, Moayeri N, van Geffen G-J, Bruhn J, Renes S, Bigeleisen PE, Groen GJ (2015) Different approaches to ultrasound-guided thoracic paravertebral block: an illustrated review. Anesthesiology 123:459–474

    Article  PubMed  Google Scholar 

  66. Pace MM, Sharma B, Anderson-Dam J, Fleischmann K, Warren L, Stefanovich P (2016) Ultrasound-guided thoracic paravertebral blockade: a retrospective study of the incidence of complications. Anesth Analg 122:1186–1191

    Article  PubMed  Google Scholar 

  67. Marhofer D, Marhofer P, Kettner SC, Fleischmann E, Prayer D, Schernthaner M, Lackner E, Willschke H, Schwetz P, Zeitlinger M (2013) Magnetic resonance imaging analysis of the spread of local anesthetic solution after ultrasound-guided lateral thoracic paravertebral blockade: a volunteer study. Anesthesiology 118:1106–1112

    Article  CAS  PubMed  Google Scholar 

  68. Meierhenrich R, Hock D, Kühn S, Baltes E, Muehling B, Muche R, Georgieff M, Gorsewski G (2011) Analgesia and pulmonary function after lung surgery: is a single intercostal nerve block plus patient-controlled intravenous morphine as effective as patient-controlled epidural anaesthesia? A randomized non-inferiority clinical trial. Br J Anaesth 106:580–589

    Article  CAS  PubMed  Google Scholar 

  69. Khalil KG, Boutrous ML, Irani AD, Miller CC, Pawelek TR, Estrera AL, Safi HJ (2015) Operative intercostal nerve blocks with long-acting bupivacaine liposome for pain control after thoracotomy. Ann Thorac Surg 100:2013–2018

    Article  PubMed  Google Scholar 

  70. Gebhardt R, Mehran RJ, Soliz J, Cata JP, Smallwood AK, Feeley TW (2013) Epidural versus ON-Q local anesthetic-infiltrating catheter for post-thoracotomy pain control. J Cardiothorac Vasc Anesth 27:423–426

    Article  PubMed  Google Scholar 

  71. Fortier S, Hanna HA, Bernard A, Girard C (2012) Comparison between systemic analgesia, continuous wound catheter analgesia and continuous thoracic paravertebral block: a randomised, controlled trial of postthoracotomy pain management. Eur J Anaesthesiol 29:524–530

    Article  CAS  PubMed  Google Scholar 

  72. Fiorelli A, Izzo AC, Frongillo EM, Del Prete A, Liguori G, Di Costanzo E, Vicidomini G, Santini M (2016) Efficacy of wound analgesia for controlling post-thoracotomy pain: a randomized double-blind study†. Eur J Cardiothorac Surg 49:339–347

    Article  PubMed  Google Scholar 

  73. Ju H, Feng Y, Yang B-X, Wang J (2008) Comparison of epidural analgesia and intercostal nerve cryoanalgesia for post-thoracotomy pain control. Eur J Pain 12:378–384

    Article  PubMed  Google Scholar 

  74. Sbruzzi G, Silveira SA, Silva DV, Coronel CC, Plentz RDM (2012) Transcutaneous electrical nerve stimulation after thoracic surgery: systematic review and meta-analysis of 11 randomized trials. Rev Bras Cir Cardiovasc órgão Of da Soc Bras Cir Cardiovasc 27:75–87

    Article  Google Scholar 

  75. Mac TB, Girard F, Chouinard P, Boudreault D, Lafontaine ER, Ruel M, Ferraro P (2005) Acetaminophen decreases early post-thoracotomy ipsilateral shoulder pain in patients with thoracic epidural analgesia: a double-blind placebo-controlled study. J Cardiothorac Vasc Anesth 19:475–478

    Article  CAS  PubMed  Google Scholar 

  76. Singh H, Bossard RF, White PF, Yeatts RW (1997) Effects of ketorolac versus bupivacaine coadministration during patient-controlled hydromorphone epidural analgesia after thoracotomy procedures. Anesth Analg 84:564–569

    CAS  PubMed  Google Scholar 

  77. Senard M, Deflandre EP, Ledoux D, Roediger L, Hubert BM, Radermecker M, Libbrecht D, Joris JL (2010) Effect of celecoxib combined with thoracic epidural analgesia on pain after thoracotomy. Br J Anaesth 105:196–200

    Article  CAS  PubMed  Google Scholar 

  78. Argiriadou H, Papagiannopoulou P, Foroulis CN, Anastasiadis K, Thomaidou E, Papakonstantinou C, Himmelseher S (2011) Intraoperative infusion of S(+)-ketamine enhances post-thoracotomy pain control compared with perioperative parecoxib when used in conjunction with thoracic paravertebral ropivacaine infusion. J Cardiothorac Vasc Anesth 25:455–461

    Article  CAS  PubMed  Google Scholar 

  79. Esme H, Kesli R, Apiliogullari B, Duran FM, Yoldas B (2011) Effects of flurbiprofen on CRP, TNF-α, IL-6, and postoperative pain of thoracotomy. Int J Med Sci 8:216–221

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  80. Nesher N, Ekstein MP, Paz Y, Marouani N, Chazan S, Weinbroum AA (2009) Morphine with adjuvant ketamine vs higher dose of morphine alone for immediate postthoracotomy analgesia. Chest 136:245–252

    Article  CAS  PubMed  Google Scholar 

  81. Joseph C, Gaillat F, Duponq R, Lieven R, Baumstarck K, Thomas P, Penot-Ragon C, Kerbaul F (2012) Is there any benefit to adding intravenous ketamine to patient-controlled epidural analgesia after thoracic surgery? A randomized double-blind study. Eur J Cardiothorac Surg 42:e58–e65

    Article  PubMed  Google Scholar 

  82. Zakkar M, Frazer S, Hunt I (2013) Is there a role for gabapentin in preventing or treating pain following thoracic surgery? Interact Cardiovasc Thorac Surg 17:716–719

    Article  PubMed  PubMed Central  Google Scholar 

  83. Solak O, Metin M, Esme H, Solak O, Yaman M, Pekcolaklar A, Gurses A, Kavuncu V (2007) Effectiveness of gabapentin in the treatment of chronic post-thoracotomy pain. Eur J Cardiothorac Surg 32:9–12

    Article  PubMed  Google Scholar 

  84. Grosen K, Drewes AM, Højsgaard A, Pfeiffer-Jensen M, Hjortdal VE, Pilegaard HK (2014) Perioperative gabapentin for the prevention of persistent pain after thoracotomy: a randomized controlled trial. Eur J Cardiothorac Surg 46:76–85

    Article  PubMed  Google Scholar 

  85. Yoshimura N, Iida H, Takenaka M, Tanabe K, Yamaguchi S, Kitoh K, Shirahashi K, Iwata H (2015) Effect of postoperative administration of pregabalin for post-thoracotomy pain: a randomized study. J Cardiothorac Vasc Anesth 29:1567–1572

    Article  CAS  PubMed  Google Scholar 

  86. Matsutani N, Dejima H, Takahashi Y, Kawamura M (2015) Pregabalin reduces post-surgical pain after thoracotomy: a prospective, randomized, controlled trial. Surg Today 45:1411–1416

    Article  CAS  PubMed  Google Scholar 

  87. Imai Y, Imai K, Kimura T, Horiguchi T, Goyagi T, Saito H, Sato Y, Motoyama S, Nishikawa T, Minamiya Y (2015) Evaluation of postoperative pregabalin for attenuation of postoperative shoulder pain after thoracotomy in patients with lung cancer, a preliminary result. Gen Thorac Cardiovasc Surg 63:99–104

    Article  PubMed  Google Scholar 

  88. Mishra A, Nar AS, Bawa A, Kaur G, Bawa S, Mishra S (2013) Pregabalin in chronic post-thoracotomy pain. J Clin Diagn Res 7:1659–1661

    PubMed  PubMed Central  Google Scholar 

  89. Wahlander S, Frumento RJ, Wagener G, Saldana-Ferretti B, Joshi RR, Playford HR, Sladen RN (2005) A prospective, double-blind, randomized, placebo-controlled study of dexmedetomidine as an adjunct to epidural analgesia after thoracic surgery. J Cardiothorac Vasc Anesth 19:630–635

    Article  CAS  PubMed  Google Scholar 

  90. Ramsay MAE, Newman KB, Leeper B, Hamman BL, Hebeler RF, Henry AC, Kourlis H, Wood RE, Stecher JA, Hein HAT (2014) Dexmedetomidine infusion for analgesia up to 48 hours after lung surgery performed by lateral thoracotomy. Proc (Bayl Univ Med Cent) 27:3–10

    Google Scholar 

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  1. Department of Anesthesiology and Intensive Care Medicine, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey

    Mukadder Orhan Sungur & Mert Şentürk

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    Mert Şentürk

  2. Department of Anaesthesiology and Intensive Care, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey

    Mukadder Orhan Sungur

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Sungur, M.O., Şentürk, M. (2017). Pain Management Following Thoracic Surgery. In: Şentürk, M., Orhan Sungur, M. (eds) Postoperative Care in Thoracic Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-19908-5_17

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